Taxi um... ambulance driver or Professional

[spenac]

BEorP did you forget to check yes on the poll? Because based on your responses we should not be allowed to think, we should just be taxi drivers or ambulance drivers as seems to be correct name.

[spenac]

BEorP sorry if any posts seem like a personal attack don't mean it that way. I guess if I worked in a city where it was only 10 minutes to hospital on long transport and we had lots of ambulances maybe this would not get to me. But from my end of the world I see no value in wasting ambulance time and limited resorces to transport any and all 911 callers. The taboo word common sense comes in and says hey I should be able to use my brain to say no to someone with no medical complaint. I just cannot see us being looked at as professionals as long as we have no ability to use good judgement. Hope we're good no offense meant just on a rant rampage today.

[EMS49393]

I am not a taxi driver. I am a paramedic, and I have a job to do. Regardless of the situation, I will always do the best job I can. EMS abuse will always be there, just as use of the ER as a family physician will always be there. The problem is bigger than EMS, bigger than education, bigger than hospitals, perhaps bigger than insurance companies.

It stinks that we have to transport people we know do not have a medical emergency, however it's our job. We can fight the good fight to try to change our protocols, but the fact of the matter is, any medical director in his right mind wouldn't implement any protocols reguarding refusing a patient transport without having 100% confidence in their paramedics. After reading all the whining about education, begging for more drugs with less education, having five thousand levels of EMT, how can you expect that doctor to want to put his license on the line in such a way as to deny a patient a thorough medical evaluation by an EDUCATED professional, such as a doctor. Turn paramedic into four year degree, EMT into a two year degree, eliminate all the in-betweens, employ the use of a exam that is actually a challenge. Perhaps we can get our medical directors attention if EVERY provider has the same education and license.

It's a shame you feel that you are a taxi driver. Perhaps it's time to for you to a) find a new career, or get the appropriate level of education and help to push through regulations increasing educational standards and licensing requirements.

In the words of my boss, "Don't be a sidewalk pisser."

[spenac]

I am not a taxi driver. I am a paramedic, and I have a job to do. Regardless of the situation, I will always do the best job I can. EMS abuse will always be there, just as use of the ER as a family physician will always be there. The problem is bigger than EMS, bigger than education, bigger than hospitals, perhaps bigger than insurance companies.

It stinks that we have to transport people we know do not have a medical emergency, however it's our job. We can fight the good fight to try to change our protocols, but the fact of the matter is, any medical director in his right mind wouldn't implement any protocols reguarding refusing a patient transport without having 100% confidence in their paramedics. After reading all the whining about education, begging for more drugs with less education, having five thousand levels of EMT, how can you expect that doctor to want to put his license on the line in such a way as to deny a patient a thorough medical evaluation by an EDUCATED professional, such as a doctor. Turn paramedic into four year degree, EMT into a two year degree, eliminate all the in-betweens, employ the use of a exam that is actually a challenge. Perhaps we can get our medical directors attention if EVERY provider has the same education and license.

It's a shame you feel that you are a taxi driver. Perhaps it's time to for you to a) find a new career, or get the appropriate level of education and help to push through regulations increasing educational standards and licensing requirements.

In the words of my boss, "Don't be a sidewalk pisser."

Your medical director would not issue a protocol to refuse transport to someone that has no medical complaint at all!!!!! That shocks me. As far as more education, I do agree we need a more standard requirement for education and should be higher than most current programs. Don't fully agree with 4 year degree especially if still just transporting everyone and not using our brains, sadly even if we were all 4 year degreed paramedics most directors still can not or will not risk use of free will. As far as leaving EMS not going to happen. Still love doing it. I used to own my own business made more money but wasn't happy. I am despite what my rants today sound like very happy working EMS as I do get to make a difference in peoples lives. Really hope my rants today make others think, and work to get where they can think. Even with all the levels medical directors could sign off to only allow certain levels to work for them. In my part of the world the expression is quit pissing into the wind, because when you do piss in the wind you only take one problem and turn it into a bigger messier one.

You know I agree most are not just taxi drivers but it illustrates the point. Be proud of what we do but lets work to change for the better. Talk with your directors might find a few that are confident in their paramedics ability to think at least a little. Until the worlds aperfect place we'll keep doing our job here at the end of nowhere to.

[spenac]

Good night be safe hope havn't stepped on any toes. Ranting done for the night.

[Ridryder 911]

Okay, no one realizes how important our position and job is than me. With this is in mind, we also need to stand back and look at our job as well. (Forest & trees analogy would do well here) We are there to transport the sick and injured to the hospital. Yes, that is the main objective. The main point of our existence is to stabilize and prevent further injuries and harm to the patient during transport.

In reality, and unfortunately majority of EMS personal is not educated enough to perform adequate triage skills. Now, before you jump to conclusions, I am not discussing MCI casualty type scenario, I am discussing day to day ER triage, involving those that present with difficult scenarios and symptomology than the obvious trauma casualty. Even the government agrees to this, as per EMT's and even Paramedics are not to initially perform triage and assessment in the ED setting. Sorry, that 10 month course did not cover enough. Are you going to flag that non life threatning rash on the child? Only to later find out that it was meningococcal rash and the child arrested. Yes, sure, there are some that could do an excellent job...but overall the education coming from a junior high level text book is not enough.

Spenac, I don't understand the continuation and ranting of being called an "taxi cab". Sorry, there are times, we are used inappropriately and this will happen but it will always occur as long as there is any medical programs. As I inform newbies, it is just as easy to transport them sometimes than to "flag" the patient. You are already there...besides, are you really sure that patient does not need medical attention? I see way too many new medics that feel that their position is far more important than it really is. The same thing in the major ER's when you see the patient with dental carries why you attempt to take care of the GSW at the same time. It is part of the beast of the job... yes, that is what it is a .. job. As well, since it is such...validation of services is needed to maintain your position.

Remember : You are there for the patient, not the other way around.

You describe a medical director not being comfortable not allowing non-transports. Let's review some medical directors positions. I know of one that has close to 150 Paramedics and another 200 EMT's under his direction. Do you think he would ever time enough, to know each ones level and competency level in even non-emergency scenarios. I agree, there is abuse.. but it may partially be the EMS fault. How much education did you place in the community on notifying an use of the EMS? Does the EMS provide an alternative non emergency transport unit or help establish other means of transport, such as volunteer transport vans, etc.?

As I tell many, before complaining attempt to have a solution of the problem.

[CodeBlueEMT]

This is an easy call, just blame all the lawyers.

Shayne

[spenac]

Rid, you seem to miss the point of my rant. My point is that if we have to transport every caller regardless that they have no medical or trauma complaint we are acting as a taxi driver. Come on is there any way you can say we are professional if we drive the caller that wants to go eat at the hospital but has no medical complaints, by taking a person to eat we are being taxi drivers. I am not asking that we choose to deny somebody with a medical complaint. In another post I mentioned someone that clearly stated they just needed the ambulance to get them past the border patrol checkpoint and people were saying we should take her even though we had no current medical complaint. To transport her we would be a taxi driver.

Now as to us providing other services there are taxis available. In Texas if person has medicaid they can get receive funds from the transportation division to travel to doctors, they can even receive money for airplane tickets, hotels, and meals. There is no reason for the ambulance to take a person with no medical complaint. We do try to educate the public.

My rant is over on taxi cab I just hope it gets people to realize not all services have the benefit of more ambulances to take over coverage. In the city transport and paperwork would be shorter. Paper work on denial of transport is more complex and takes longer so probably not worth it in the city. I hope did not step on toes. I am glad I work in an area where I can think though at times it would be nice to pick up the phone and let a Doctor decide for me. The city and even most rural areas have more services available than the area I am in, but I still am sure theres bound to some even in more remote areas than us.

A key for all of us to remember is that what works in your area may not be practical in my area and vis a versa. There should never be a complete firm no more no less nationwide protocol developed. I can see benefit of having a minimum nationwide protocol that expands everyones capabilitys but allows medical directors to expand the scope of practice of their people to fit the environment worked in.

To all my fellow EMS Professionals have a great day and keep stretching our way of thinking.

[ALERT Medic]

"Defensive Medicine." The way of the future.

Take care,

chbare.

My vote for best comment to sum it all up with. Thanks chbare.

[JPINFV]

For EMS to be seen as more than taxi drivers, then all levels needs to be able to refuse the "stubed toe" call. It will not help the profession if every interfacility company under the sun is still willing to transport these patients and you will [hopefully] never have EMT-Basics being able to refuse a transport. There are just too many of us that are too stupid and/or lazy to implement this.